Key result
Sirolimus-eluting balloons fail to show noninferiority to paclitaxel-eluting balloons for late lumen loss in ISR.
Why the study?
Current therapy for in-stent restenosis relies on drug-eluting stents or balloons, motivating a direct comparison between a novel sirolimus-eluting balloon and a paclitaxel-eluting balloon.
Does a sirolimus-eluting balloon catheter reduce in-segment late lumen loss compared to a paclitaxel-eluting balloon catheter in patients with coronary in-stent restenosis?
RCT (n=145)
randomized
Does a sirolimus-eluting balloon catheter reduce in-segment late lumen loss compared to a paclitaxel-eluting balloon catheter in patients with coronary in-stent restenosis?
A novel sirolimus-eluting balloon failed to demonstrate noninferiority to a paclitaxel-eluting balloon for angiographic late lumen loss in patients with coronary in-stent restenosis.
Sirolimus-eluting balloon not noninferior to paclitaxel-eluting balloon for late lumen loss; challenges substitution and leaves open its role in coronary in-stent restenosis.
BACKGROUND: Current therapy for in-stent restenosis (ISR) is based on drug-eluting stents (DES) or drug-eluting balloon catheters. This prospective randomized study compared the efficacy of a novel sirolimus-eluting balloon (SEB) catheter to that of a paclitaxel-eluting balloon (PEB) catheter for the treatment of bare-metal stent (BMS-ISR) or DES-ISR. METHODS: A total of 145 patients with 158 BMS or DES-ISR lesions were randomly assigned to the treatment with either SEB or PEB. The in-segment late lumen loss at 12 months, the 12-month incidence of binary ISR, and major adverse cardiac events (cardiac death, nonfatal acute myocardial infarction, or target lesion revascularization) were compared between groups. CONCLUSIONS: The noninferiority of SEB relative to PEB in the treatment of BMS/DES-ISR with respect to late lumen loss was not confirmed. REGISTRATION: URL: https://www.clinicaltrials.gov; Unique identifier: NCT03667313.
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Pleva et al. (2025) conducted an RCT in Coronary In-Stent Restenosis (n=145). Sirolimus-eluting balloon (SEB) catheter vs. Paclitaxel-eluting balloon (PEB) catheter was evaluated on In-segment late lumen loss at 12 months (p=>0.999). The noninferiority of a sirolimus-eluting balloon relative to a paclitaxel-eluting balloon for treating coronary in-stent restenosis regarding late lumen loss was not confirmed (P>0.999).
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